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Intracranial pressure in African children with cerebral malaria

C R Newton1, F J Kirkham, P A Winstanley

  • 1Kenya Medical Research Institute, Kilifi Coastal Unit.

Lancet (London, England)
|March 9, 1991
PubMed

Insights

Cerebral malaria in Kenyan children often causes dangerously high intracranial pressure, linked to increased cerebral blood volume. Reducing this pressure may improve outcomes and survival rates in affected children.

Area of Science:

  • Pediatrics
  • Neurology
  • Infectious Diseases

Background:

  • Cerebral malaria is a severe complication of Plasmodium falciparum infection.
  • Intracranial hypertension is a recognized complication in pediatric cerebral malaria.
  • The exact mechanisms and impact of intracranial pressure on outcomes require further elucidation.

Purpose of the Study:

  • To measure opening cerebrospinal fluid (CSF) pressure in Kenyan children with cerebral malaria.
  • To investigate the association between intracranial hypertension and clinical features, including mortality.
  • To explore the potential role of intracranial pressure management in cerebral malaria.

Main Methods:

  • Measurement of opening lumbar cerebrospinal fluid pressure using a paediatric spinal fluid manometer.
  • Clinical assessment of 26 Kenyan children diagnosed with cerebral malaria.
  • Analysis of pressure readings in relation to clinical presentation and outcomes.

Main Results:

  • All measured CSF pressures were above the normal range (mean 22.6 cm CSF).
  • Elevated intracranial pressure was observed in all evaluated children.
  • Clinical findings suggest a significant role of intracranial hypertension in the pathogenesis and mortality of pediatric cerebral malaria.

Conclusions:

  • Intracranial hypertension is a critical factor in pediatric cerebral malaria, potentially contributing to mortality.
  • Increased cerebral blood volume is hypothesized as the cause of raised intracranial pressure.
  • Further research into lowering intracranial pressure could offer therapeutic benefits for cerebral malaria patients.

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